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Vaccination advice

Hi all
Im moving to Saigon in August and have a problem. I just learned that the Hepatitis A and B vaccines that are recommended need to be administered over 6 months.  I dont have 6 months to wait around so my question is can i get the first shots here at home and the rest when i move to Saigon?
Any advice would be greatly appreciated.

Sorry no yes/no answer. You can do that in theory but I see three options:

1. Get first injections in your country, then seconds here. It might be important that the part 1 and part 2 vaccines match, yes? Ideally you bring the part 2 meds with you for future injection. Does your pharmacy permit that?

2. Get the second injections here with meds that match well enough. Probably same brand is not available. You want find out the brand of meds used by your doctor, then contact a clinic here for availability or substitute.

3. Just get the complete series in Saigon. Vaccinations are way cheaper here. Note that In the US I paid $125 for just one Hep A shot, tho maybe in your country you have free socialized meds.

My wife says there is a combination Hep A and B here called Twinrix, that is 1 shot administered 3 times in months 1,2, and 6.

In either case, you can contact  popular expat clinic "Family Medical Practice" (google) by email and ask for prices and specific vaccine names. As an international clinic, they will give you a price on the high side. You can also go to a Vietnamese clinic TBD for even lower prices but maybe different vaccines.

I asked about this recently and was told that first you must be checked to see if you have either of these, after that you can have the vaccinations. Hep B is very common in Viet Nam.

colinoscapee :

I asked about this recently and was told that first you must be checked to see if you have either of these, after that you can have the vaccinations. Hep B is very common in Viet Nam.

There was a 2016 outbreak of Hep A in Honolulu originating from bad sushi at a chain restaurant.  My wife and I got our first shot then, free from our insurer.  I then decided to follow up with Hep B.  My wife's doctor, a second generation Vietnamese, had her tested and found that she had previously had Hep B, who knows when?  We know medical records in Vietnam are bad to non-existent.  She recommended a single shot for my wife to act as a booster.  I took the 3 shots.  Also note that the time between the Hep A vaccinations is a minimum 6 months.  Because of the difference in the schedules the combined vaccines may mean a certain waste of materials but they make it simpler for the patient.  Hep C is more prevalent in VN than the US but transmission is more difficult than A or B.  As I understand it, vaccination is really not needed unless your spouse or partner is known to be infected.

Some excellent advice for me here thank you.  I think my best option is to get the typhoid vaccine here in Ireland and then the twinx hep b&c vaccines on arrival. As I will be living in Saigon I should be ok but I will keep in mind to only drink bottled water.

It is not transmitted by water. Hep A is food born by food workers etc. Hep B is not as easy to get and is transmitted by being in close proximity to someone that has it. The problems are manifold for you the OP. As was said you first need to be tested to see if you have the Hep B virus or A for that matter. If your lucky and do not, then you can start the vaccine immediately. If you test positive then you must wait 6 months to see how it looks in 6 months. But you take risk by not being immunized before you arrive. I think your best option is to first be tested. Then before you begin the vaccine see which one of the manufactures they are going to use. Then contact , say, FMP HCMC and see if they have it. Good luck. Your wise to be considering it.
  a footnote: I keep wondering how safe all these tattoo shops are in VN. Not even the hospitals use good hygiene practices what does that portend for the tattoo joints. I can see Hep C going crazy here.

I feel that I need to correct this statement.

THIGV :

Hep C is more prevalent in VN than the US but transmission is more difficult than A or B.  As I understand it, vaccination is really not needed unless your spouse or partner is known to be infected.

There is currently no prophylactic vaccine for Hep c.  There is a recent curative treatment however brand named Harvoni.  The drawback to that is that the US system of keeping health care in the private sector (I hope that is apolitical enough for moderators.) has allowed the company to charge over $50,000 for a course of treatment.  A generic formulation could be as low as $68.  One article I saw calculated that the government could buy 100% of the stock in this company and treat every infected person in the US for free and spend fewer dollars than the government will spend through the VA and Medicare. 

I read that there are negotiations underway now to license this cure to low income countries.  Hopefully for the sake of its citizens, even if they are IV drug users, the government of Vietnam will be among those involved.

Quick update
After consulting with my GP im a bit lost. He tells me the test for Hep A/B will take anything up to two months to come back (Ireland health system is in an appalling state). I can get the Typhoid vaccine easily enough but the Hepititus B and A  tests and vaccine administration will take longer than i have. I have emailed Family Medical Practice with the same query.  I am in good health and have no major underlying health problems or conditions so i think i will just have to get Typhoid before i leave and then book myself in on arrival for the other tests. If anyone has any more advice id appriciate it.

If you are already in the country, don't bother with the Hep A/B tests, just get the vaccines.  The only reason my wife's doctor had her tested was because she was coming from Vietnam which is high prevalence.  Even in the odd chance that you were previously infected, the vaccines will not hurt, just as her doctor had her take one more dose of the B.

Thanks for the advice. I will be getting typhoid,hepA and tetnus before I go so I'll just be careful and get myself the twinrx vaccines when I arrive. Huge weight of my mind here,thanks again.

Declan Reilly :

Thanks for the advice. I will be getting typhoid,hepA and tetnus before I go so I'll just be careful and get myself the twinrx vaccines when I arrive. Huge weight of my mind here,thanks again.

If you already will have the first A at home, there is no need for the twinrx combined vaccine.  You can take the straight B on arrivel and follow the B schedule.  Take the final A separately or as a combined A/B if the timing works out.  Remember the final A must be not less than 6 months from the first so taking the combined vaccine means that you will have taken two wasted doses of A before your final A dose.  If it seems confusing just draw it out on a horizontal timeline.

To OP:
  I think THIGV may have given you misleading information when he says the Hep A vaccine shot" must be not less than 6 months form the first one". Actually they must be taken AT LEAST 6 months apart. So take the first then anytime after 6 months get the second. Hope this clarifies the issue

THIGV :

the final A must be not less than 6 months from the first

Diazo :

Actually they must be taken AT LEAST 6 months apart.

I am sorry but aren't "not less than" and "at least" the same thing?  Anyway if its easier to follow "at least" that's fine with me.   :)

@ THIGV
   My bad, your right, they are one in the same. Don't know what I was thinking.

To follow up on the Hep C cure (not vaccine), a company in India has been licensed to produce the product.  https://www.nytimes.com/2017/07/25/opin … 2:23413361  Hopefully, the government in Vietnam has or soon will approve its importation and can find the funds to make it available to the native population.  Infected expats, and there are surely some, should be able to buy it for about $1000 for the full 84 day treatment.

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